Source: OncologyStat Author: Thomas F. Pajak CHANDLER, Ariz. (EGMN) - Human papillomavirus infection is clearly a prognostic factor in patients with head and neck cancer. But whether HPV status can be used to guide treatment decisions is far from clear, according to speakers at a head and neck cancer symposium sponsored by the American Society for Radiation Oncology. The Investigator's Perspective Across trials that tested different regimens in heterogeneous populations with head and neck cancer, patients with HPV-positive disease have had at least a one-half reduction in the risk of death, relative to their counterparts with HPV-negative disease, began Dr. Maura L. Gillison, a professor of medicine and epidemiology at Ohio State University in Columbus. "Clearly, HPV tumor status is prognostic," she said, citing multiple factors that might explain why HPV-positive patients have better survival outcomes. Certain attributes that track with HPV positivity - better performance status, younger age, lower T stage, and absence of anemia - are also favorable prognostic factors, she noted. And HPV positivity confers a better response to both radiation therapy and induction chemotherapy. In addition, data from the RTOG (Radiation Therapy Oncology Group) 0129 trial of chemoradiation show that HPV-positive patients are less likely than their HPV-negative peers to experience a locoregional failure and to develop second primaries, although rates of distant metastases are similar. "What we can conclude at this point is that the relative survival for the HPV-positive patient appears independent of therapy, as long as that therapy is within the standard of [...]